Plastic Surgeon Dr. Jhonny Salomon and His Beauty Fixes

Q: What additional procedures are needed for masterful results with a face and neck lift? A: Many patients don’t realize that a facelift treats only the face, the cheeks, the nasolabial folds and the corners of the mouth. The upper part, above the brow and the eyes, are not treated by the facelift. There are several complementary procedures that assist in getting optimum results.

A patient who has a low position of the brow and aging of the forehead should consider an endoscopic forehead lift simultaneously. It’s a short procedure about 45 minutes, and it repositions the eyebrow and gives it a more youthful look. Additionally it smooths out forehead wrinkles and the area in between the brow wrinkles. The eye itself is treated by eyelid surgery, which is two parts: the upper lid and the lower lid. For the upper lid you treat the excesses of skin and fat. The lower lid treats the bags and the junction line between the lower lid and the cheek in addition to the skin. At times, the endoscopic forehead and eyelid procedures are performed in conjunction.

Chin implants are the last of the procedures to do in tandem with a facelift. Some patients have a recessed chin from an early age and will require a chin implant. The material used for the implant is a hard silicone that has endured the test of time and is very safe.

What percentage of your patients require these additions? A: About 50 to 60 percent of my patients require the eyelid and forehead procedure at the same time as the face and neck. Thirty to 40 percent require an eyebrow lift. Only five to 10 percent of my patients require a chin implant at the same time.

Q: How long is the duration of a facelift? A: Anywhere from two to three to four hours. If it’s a secondary facelift it may be four hours — if you have to reposition and correct, it takes longer. But the corrective patients have very good results.

Q: Where do you see facial aging most? Where does it start? A: It’s hereditary and very individual. Some facial aging starts in the jowl, some in the neck or the brow. Others start in the eye area.Some people lose volume first while others have laxity first. Everyone is different as to where and when the aging process takes effect.

Q: How do you hide the incisions of the facelift? A: I start with the hairline and go above the ear and then inside the ear — behind the tragus. Usually I come around the lobule and back into the hair. In doing that you make the incisions as inconspicuous and non-visual as possible.

Q: Do you perform corrective face reconstruction? A: I have many patients who have had one or two facelifts prior and they need corrections. I’ve had very successful results with corrective procedures. But there are some patients who have had too many procedures and injectables, which hardened into the skin and created deformities that are very difficult to help.

Q: Tell me about Kybella injectable. A: It’s a new injectable that had just been FDA-approved and is for removing fat under the chin [only]. Its scientific name is deoxycholic acid. It’s injected below the skin and causes lysis [fat cell disintegration]. With the right amount, injectable patients will get great resolution of fat under the chin. It’s a very quick procedure, and the patient may be a little bit swollen after, so we recommend a month in between injections. It’s quite effective for that specific issue.